Hospital Improves Patient Readmission Rates

Bethel’s YK Delta Regional Hospital is 6th in the Nation in improving patient readmission rates according to recent CMS Quality Improvement report.

YKHC’s team of health care professionals has been working on a comprehensive project to reduce harm, and improve patient care in the health care environment within Bethel’s YK Delta Regional Hospital (YKDRH), as well as outside of the hospital when patients are discharged.

The Bethel YKDRH readmission rates declined from a high of 12 readmits per 100 patient discharges to a low 2 readmits per 100 patients discharged over the period of 4th quarter 2011 (September to December) to 1st quarter 2013 (January to March).

As part of regulatory measures and standards issued by the Centers for Medicaid and Medicare Services (CMS), YKHC participates in a national reporting system which monitors hundreds of key indicators on how YKHC performs as a hospital and as a health organization as a whole. According to the latest CMS dataset released in early August, YKHC had two patients readmitted for the first quarter of 2013 calendar year. This was the lowest number of readmissions per discharges among Alaska’s nine inpatient hospitals who participate. This is a tremendous success story, especially since YKDRH was one of four hospitals penalized under the CMS hospital Readmissions Reduction Program prior to the detailed report’s release.

According to the report, Bethel, out of 320 communities, engaged in a quality improvement initiative to improve care transitions. The report stated Bethel had the 4th largest improvement nationally in admissions, and out of re-admissions (at admissions-per-1000 rank) Bethel had the sixth largest improvement nationally in readmissions, compared to hundreds of facilities across the nation who also participate in the report.

Key interventions included participation and commitment by our Chief Nurse Executive Barbara Jacobson and Dr. Ron Bowerman. Education / implementation was among one of YKHC’s inpatient staff from Behavioral Health, and contributions with the Hospital Engagement Network (HEN) group.

According to Barbara Jacobson, Chief Nursing Executive for YKHC, “Although there isn’t one specific reason as to what has caused significant improvements, we can deduce that our care environment to reduce harm improved tremendously with our Electronic Medical Record initiative, among several other efforts to implement overall staff and education awareness to reduce patient falls and enhancing nurse  and provider education. Availability of Yup’ik translators has also been extremely useful for communicating with our aging elder population to provide clear discharge instructions.”

The aim of the Bethel hospital’s efforts via the Hospital Engagement Network, or HEN initiative, is to systematically monitor quality of care, and to prioritize initiatives to increase patient safety, such as reducing falls, among others. Some of the team’s “defining moments” included embracing a comprehensive approach by providing patients with detailed discharge instructions upon admission and enhancing communication and education of nursing staff on CORE measures to include in the patient’s nursing care plans after they are released.

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